Department of Anesthesiology, Clement J. Zablocki Veterans Administration Medical Center, 5000 W. National Avenue, Milwaukee, WI 53295, USA.
J Anesth. 2011 Feb;25(1):1-9. doi: 10.1007/s00540-010-1042-y.
We tested the hypothesis that elevated postoperative interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations are associated with short- and medium-term impairment of cognitive functions in patients after coronary artery surgery using cardiopulmonary bypass.
Eighty-six age- and education-balanced patients ≥55 years of age undergoing elective coronary artery bypass surgery with cardiopulmonary bypass and 28 nonsurgical controls with coronary artery disease were enrolled. Recent verbal and nonverbal memory and executive functions were assessed before surgery and at 1 week and 3 months after surgery using a cognitive test battery. IL-6 concentrations were measured before surgery and 4 h after cardiopulmonary bypass, and CRP concentrations were measured before surgery and at 24 and 72 h after anesthetic induction. Overall cognitive function between high and low biomarker concentration groups was analyzed by the Wilcoxon rank-sum test.
Recent memory was at least 1 standard deviation (SD) impaired at 1 week and 3 months in the high-CRP compared with low-CRP and in the high-IL-6 compared with low-IL-6 concentration groups. Overall cognitive function was significantly (P = 0.04 and P = 0.01, respectively) different between the high- and low-CRP concentration groups (CRP assayed 24 h after anesthetic induction) at both 1 week and 3 months. Overall cognitive function was also significantly (P = 0.04) different between the high and low-IL-6 concentration groups at 1 week after surgery.
The results suggest that elevated postoperative IL-6 and CRP concentrations are associated with the subsequent development of short- and medium-term impairment of cognitive functions after coronary artery surgery.
我们通过心肺转流术检测了术后白细胞介素 6（IL-6）和 C 反应蛋白（CRP）浓度升高与冠状动脉旁路手术后短期和中期认知功能障碍的相关性假说。
纳入 86 名年龄和教育程度匹配的≥55 岁择期冠状动脉旁路手术患者（使用心肺转流术）和 28 名非手术对照患者（冠状动脉疾病）。使用认知测试套件，在术前和术后 1 周和 3 个月评估近期的言语和非言语记忆以及执行功能。在术前和心肺转流术后 4 小时测量 IL-6 浓度，在术前和麻醉诱导后 24 和 72 小时测量 CRP 浓度。通过 Wilcoxon 秩和检验分析高、低生物标志物浓度组之间的总体认知功能。
与低 CRP 浓度组相比，高 CRP 浓度组的近期记忆在术后 1 周和 3 个月时至少降低了 1 个标准差（SD），高 IL-6 浓度组也低于低 IL-6 浓度组。高、低 CRP 浓度组（麻醉诱导后 24 小时测定 CRP）术后 1 周和 3 个月的总体认知功能均有显著差异（P = 0.04 和 P = 0.01）。术后 1 周时，高、低 IL-6 浓度组的总体认知功能也有显著差异（P = 0.04）。
研究结果表明，术后 IL-6 和 CRP 浓度升高与冠状动脉旁路手术后短期和中期认知功能障碍的发生相关。
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